S1060 Comparison of Demographics and Phenotypic Behavior of Inflammatory Bowel Disease Among Southeast Asians and Caucasians at a Tertiary Center in Houston

Introduction: The incidence and prevalence of inflammatory bowel disease (IBD) has increased in Southeast Asians (SEA). Our objective was to determine clinical features and phenotype of IBD in SEA in the U.S. in comparison to Caucasians. Methods: Seventy SEA (38 Crohn’s disease (CD), 32 Ulcerative Colitis (UC)) patients were compared to 70 consecutive White patients (50 CD, 20 UC patients) using Chi-square and Fischer’s exact test. Bonferroni’s correction was applied for multiple comparisons. Results: UC was more prevalent in SEA compared to Caucasians (45.7% vs 28.5%, p=0.03). 64% of SEA CD patients were men compared to 28% of White CD patients (p< 0.001). Majority of SEA CD patients were diagnosed between the age of 17-40 (p=0.008). B1 disease was more prevalent in SEA with CD and B2 disease was more common in Caucasians (p< 0.01). SEA with CD had a reduced need for bowel surgery (21% vs 52% in the non-SEA group, p=0.002) and hospitalizations (21% vs 62% respectively, p value< 0.01). Ileocolonic disease was the most prevalent location of CD in both groups (71% & 56% respectively for SEA & White patients). Majority (85%) of the White patients with UC were women compared to 51.6% in the SEA group, p value=0.005. Both the groups had predominantly pancolitis at 64% and 70% respectively, with no significant difference in median age of diagnosis, response to biologic therapy, need for surgery and hospitalizations. Conclusion: Knowledge of ethnic differences in IBD behavior, location and treatment responses can impact clinical care and treatment. A study done by Bodiwala et al also showed UC being more prevalent in South Asians with IBD (58% UC in SEA), similar to our study. Our study showed a male preponderance in the SEA CD and a female preponderance for the White UC patients. The same trend was observed in Walker et al’s study in North London. In our study, a higher rate of B2 stricturing disease was noted in Caucasians in contrast from Walker et al, where the Caucasian patients had more B3 penetrating CD. (Table) We found that SEA with IBD had milder disease with lower rate of CD/UC related surgery, hospitalizations compared to the Caucasian group, which is similar to other studies done on IBD behavior of SEA in the US. There could be a role of environmental, genetic, and dietary factors that needs to be explored further to explain the differences in severity of the disease. Table 1. - Demographics and clinical features of South Asian and Caucasian patients with Crohn's disease and Ulcerative Colitis Crohn's Disease South-East Asians (N=38)N (%) Caucasians (N=50)N (%) p-value Gender < .001 Females 13 (34.2) 35 (70) Males 25 (65.7) 15 (30) Age at diagnosis (Montreal Classification) <16 years 10 (25.6) 17 (34) 0.39 17-40 years 24 (64) 18 (36) 0.008 >40 years 4 (10) 14 (28) 0.06 Mean duration of disease in years 13.1 years 17 years 0.57 Family history of IBD 6 (15.3) 8 (16) 0.89 History of smoking 3(7) 4 (12.5) 0.95 Disease extent Ileal(L1) 10 (26.3) 12 (24.3) 0.8 Colonic(L2) 3 (7.8) 7 (14) 0.5 Ileocolonic (L3) 25 (65.7) 31 (62) 0.71 Upper GI involvement (L4) 2 (5) 6(12) 0.45 Perianal disease 10 (26.3) 12 (24) 0.71 Non-stricturing, non-penetrating disease (B1) 29 (76.3) 12 (24) < .001 Stricturing (B2) 3 (7.8) 21(42) < .001 Penetrating (B3) 6 (15.7) 13 (26) 0.24 History of bowel surgery for IBD 11 (28.9) 26 (52) 0.002 History of biologic therapy 33 (84) 46 (92) 0.27 Presence of extra-intestinal manifestations 12 (28.94) 23 (46) 0.14 Prior hospitalizations 8 (21) 31 (62) < .001 Ulcerative Colitis South-East Asians (N=32) Caucasians (N=20) Gender distribution 0.005 Females 16 (50) 17 (85) Males 16 (50) 3 (15) Median age at diagnosis 27 years 28.5 years 0.72 Family history of IBD 4 (12.9) 5 (25) 0.26 History of smoking 1 (3) 4(20) 0.07 Disease extent Ulcerative Proctitis (E1) 6 (19.3) 2 (10) 0.46 Left sided UC (E2) 5 (16.1) 4 (25) 0.71 Pancolitis (E3) 20 (64) 14 (70) 0.58 History of bowel resection 2 (6.4) 5 (25) 0.14 History of biologic therapy 18 (58%) 14 (70) 0.38 Presence of extra-intestinal manifestations 10 (32.2) 4 (20) 0.53 Prior hospitalizations 9 (29) 6 (30) 0.94

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